Protocol for Positioning and Helmet Removal-Removal of Helmet and Shoulder Pads

Manual stabilization of the cervical spine is maintained by placing one hand on each side of the athlete’s helmet.

The chin strap is cut, and all accessible internal padding is removed.

The second care provider (team physician) then slides his or her hands along each side of the mandible and stabilizes the cervical spine.

The team physician now assumes responsibility for manual stabilization of the cervical spine. The athletic trainer gently removes the helmet by first spreading the area over the cheeks. Next, the helmet is gently removed. The helmet may be rolled forward slightly to allow easy removal. Once the helmet is removed, the first care provider reassumes manual stabilization.

Removal of the shoulder pads begins with cutting the jersey and all other shirts from the neck to the waist and from the midline to the end of each arm sleeve. All straps holding the shoulder pads in place should be cut, as opposed to unbuckled, to avoid unnecessary movement. Most shoulder pad systems use lacing or strapping over the sternum to connect the two halves of the shoulder pad unit. This lacing should be cut, after which the anterior half of the shoulder pads can be opened.

Manual stabilization of the cervical spine is then shifted such that the team physician maintains stabilization by placing his or her forearms on the athlete’s chest. One hand is placed on each side of the patient’s mandible, with the fingers directed posteriorly around the base of the occiput.

With several assistants, the injured athlete is then carefully lifted while manual stabilization is maintained. The athletic trainer gently removes the shoulder pads by pulling the unit superiorly, and the athlete is gently lowered onto the spine board.

The athlete is secured to the spine board. Manual stabilization of the cervical spine is maintained until the athlete’s head is stabilized with foam blocks.